Tuesday, March 10, 2015

Medicine in America and thinking about others.

The current state of the medical care in America is simply maddening.

So, we have the ACA.. among it's many components, there's apparently a requirement now for insurance companies to have the social security number of every person who is insured, now that healthcare is seemingly inextricably tied to taxes, so when adding my newborn, I get asked for his SS#, even though he won't have one until they mail us back the card in the mail.

Here's another gigantic gripe.

Health Care practitioners in order to get better rates for malpractice insurance, require you to sign away ALL rights, and agree that any case be settled in the arbitration framework of their choosing.

Sign it with the annotation of "under duress" and listen to the condescension coming from the doctor and other folks. I have never been involved in a medical malpractice case of any type, frivolous or
otherwise, but why would I sign away my legal all legal rights?

Since when is signing away ALL legal rights considered a way we're supposed to do business in America?

Now, everything I know about contract law states that a good contract protects both (or all if more than two) equally. Why is it every single contract we run across is so one sided?

Literally one sheet of paper, out of a stack of 10 for a new patient (who's brother is already registered in the office) is about the patient and any patient specific information. The other 5 forms are legal documents stating that you accept full responsibility for all charges, independent of what the insurance company does or is supposed to do (this one is very popular of late), other somewhyat redundant affidavits of personal liability, and then the one that shows in red on the bottom:

"By signing this document you waive all rights for any medical malpractice issues that might occur outside of our specific arbitration."

This is unfortunately a paraphrase, since they don't bother to pass off a copy of the triplicate NCR form. Apparently 1 copy is for the doctor's office, 1 copy for the insurance company's records, and 1 copy for the insurance company's counsel.

What kind of a world is it we live in where the basic legal rights (to sue someone should they injure you) available to everyone as mandated by law, are precluded as a part of the the "Normal Course of Doing Business".

Another one I like to point out is the habit some offices have of signing a "Patient Privacy" document that states they can at any time, re-sell your PMI to any third party (assuming to make side cash for populating their demographics databases ), despite the HIPPA regulations prohibiting them from re-distributing or accidentally leaking your information. By signing it and by the practitioner (I saw it at a chiropractor's office) including as part of the new patient paperwork, you give them the legal release to sell it repeatedly. I refused to sign it and was told it was to protect me, when it clearly stated that is was asking me to absolve myself of all rights to privacy.

The most common response I've heard blindly parroted from practitioners and their staff when asked about having to sign financial liability or rights waiver paperwork is "It's for your protection."

It simply is not the case. It's for the practitioners business and financial protection. There isn't a single benefit to the consumer in any of the paperwork. Legal regulations are one thing, and malpractice insurance conditions to maintain the rates they want to pay are completely another.

When I have insurance that mandates a specific co-pay and little to no out of pocket for the normal services, and little eligible for deductible, why would I have to sign a document stating I am completely 100% liable? Trust is a two-way street, and it begins with the paperwork I get shoved in my face at the first visit.

Interestingly enough, doctor's in lower-income areas seem to be more demanding about this stuff than in higher income areas, understandably, they may run more risk of non-payment, but there has to be a better way than the "over-the-top" methods used today. My old pediatrician's office was in 90278, the new one is in 93036. The median income in those areas has a disparity of ~$33,000.

And maybe that's part of the problem. As a society, we treat those who have the least, the worst, and those who have the most the best. As much as I might be entrenched in looking after myself and my family, does that have to be to the detriment of everyone I may deem beneath me? In theory no, in practice all over both this country and the world at large yes.

As with all things, I can only strive to be better myself, and to attempt to teach my kids to be even better than I am. In fact, any real movement of change must be made up of it's component parts, which are all of us.

Remember that the true measure of "class" isn't how you treat those 'better' than you, but how you treat those beneath you. Professionally, personally, in every single interaction.

Remember also, that people aren't measured on how well they handle easy situations, but difficult ones. It's not easy to treat the little guys right, because theirs no likely direct benefit to you.

Think about that the next time you berate a Starbuck's employee for forgetting to put soy milk in your over-complicated latte' order. Think about that when you see your mailman showing up a few minutes late for your package.

Remember that it's not about what you say, but what you do. Make an effort to do something nice for someone, or treat someone better than they expect, and see what happens. Once a day, once a week, once a year, all that really matters is the effort and the focus on the betterment of someone other than yourself.

Maybe my perspective on the medical profession is too selfish, but I stand by the basic premise of contract law, which states that any good contract protects both parties equally.